40 years' work of a paediatric surgical ward.

The overall activity of the Surgical Ward of the Children's Department, University Medical School of Pécs, was analysed in the 40-year period of 1940-1980 in order to illustrate the rapid development in the surgical care of infants and children. A scoring system, based on the magnitude of surgical interventions and patient age, was worked out to prove this progress. The most remarkable feature of the development of paediatric surgery is that more skillful and time-consuming surgery is required in much younger patients. In order to meet the higher demands, the conditions of such a service should further be improved.

Chilaiditi's syndrome--successful surgical correction.

A 2-year-old child is presented with irregular frequent vomiting leading to a very severe marasmus. Only repeated radiological investigations revealed the hepatodiaphragmatic interposition of the colon. Two years after surgery she has nearly doubled her body-weight.

[Rare disorders in neck surgery]. / Seltene halschirurgische Erkrankungen.

The diagnosis and treatment of unusual surgical conditions of the neck in the newborn, infancy, and paediatric age-group are discussed. The median cervical cleft, the scalenus cervical rib syndrome, the cervical teratoma, changes of the thymus, tumour-like abnormalities of the large veins, calculus formation of the sub-mandibular salivary gland, severe traumatic and iatrogenic injury may all present difficult diagnostic and therapeutic problems.

Congenital duodenal obstruction: a survey of mortality.

A review is presented of 31 neonates operated upon for various types of congenital duodenal obstruction during the ast twenty years. The detailed and overall mortality was analysed by dividing the material into a ten-year, and two five-year, periods. The mortality rate in the second five-year period (1972-1976) was found to be half that of the ten-year period (1956 to 1965). The operative technique (duodenoduodenostomy), the use of atraumatic silk sutures and transanastomic feeding tube are probably the most important factors leading to better survival. Most of the surviving patients have been followed up and have so far shown no complaints directly related to the operation.

Remnants of vitelline duct: analysis of 66 cases.

In twenty years, 66 infants and children with remnants of vitelline duct requiring surgery have been admitted. The patients were classified into three groups: patient vitelline duct (20 cases); Meckel's diverticulum as the primary surgical diseases (19 patients); and Meckel's diverticulum found incidentally at surgery (27 patients). The male preponderance in the groups of patent vitelline duct and symptomatic Meckel's diverticulum was 9:1. In contrast with other data, Meckel's diverticulum requiring surgery occurred with nearly equal frequency up to fourteen years. The gravest complication in the cases of patent vitelline duct were a T-shaped protrusion of ileum and a small bowel volvulus around the fibrous cord or the patent duct; and in the cases of Meckel's diverticulum causing symptoms, intestinal obstruction, bleeding peptic ulceration or inflammation. Three deaths occurred in newborn age in connection with patent vitelline duct, and one patient died who belonged to the group of asymptomatic Meckel's diverticulum.